Breast Reduction Questions

Q: I’m interested in having breast reduction surgery. I’m 5’4, about 130 lbs, 18 years old, and wear a size 32DD. I have never been pregnant and do not nurse. No matter how thin I am, my breasts do not seem to shrink and I find it very painful to exercise. I am an avid runner and like to stay in shape. I am very unhappy with my breasts because they seem to, well.. aim down. My nipples are very large and my skin is stretched. I want to be an A, I like the look simplicity. Am I a common patient?

A: There are times when breast reduction surgery is appropriate at your age. By law, you are old enough to make your own healthcare decisions and have likely completed puberty. When large breasts cause pain, psychological discomfort or interfere in daily activity (including exercise), sometimes a breast reduction can give significant relief. Some things that warrant serious consideration are scarring, future pregnancy and future breastfeeding. Breast reduction surgery does create scars on the breasts. For many women this is a small price to pay for the relief associated with the surgery, but it definitely needs careful consideration. I definitely recommend looking at before and after photos. You should also consider the potential effect of pregnancy on your new, perky breasts. The hormones associated with pregnancy often lead to temporary enlargement of the breast tissue and many women complain about sagging breasts after the pregnancy is over. Some women also find they are unable to breast feed after having breast reduction surgery. Having said that, it is rare for me to meet a woman who regrets having a breast reduction. After doing internet research, please seek out a board certified plastic surgeon for a consultation. Together, you can determine if you are a good candidate for a breast reduction.

Q: Is there any way around that through the appeal process? Or anything else that I can do?

A: I am finding more and more instances of breast reduction surgery being excluded from coverage by health insurance plans. Unfortunately, it is unlikely that your appeal will be successful. You could consider exploring a different insurance carrier, but even when covered, there are generally very strict criteria. You may wish to consider saving for the procedure and paying out of pocket. This allows you to pick your plastic surgeon without being limited to a list of doctors proscribed by your insurance plan. It also provides you the freedom to determine whether or not the surgery would benefit you without having to go through the hoops (like courses of physical therapy, anti-inflammatory medication and repeated visits to your general practitioner) required by many insurance plans.

Q: Am I wrong in wanting to be operated on in a hospital, even though these surgery centers are accredited? It just seems safter.

A: Almost every board-certified plastic surgeon you will meet operates in at least one hospital. Having hospital privileges is a requirement for most accrediting organizations. There are several reasons why so many of us and our patients prefer surgery centers. First and foremost is patient safety. I run my own AAAASF-accredited surgery center which allows me to hand-pick the best nurses, anesthetists and other staff to help me take great care of you. I have no control over who is working in the hospital. Most surgery centers also have MUCH lower infection rates than hospitals. The second benefit is cost. Hospitals are expensive to run and that cost is passed on to you. I have no influence on the anesthesia and facility fees that they will charge my patients. I am much better able to control costs in my own center and I pass that savings on to you. Additionally, I am able to offer better service in my own operating room than I am at a hospital. I offer a variety of surgical dates and times and my staff is particularly attuned to your needs. It’s equivalent to the service difference you would notice when comparing a fast food chain to a sit down meal at a family owned restaurant.

Q: I’m 19 years old, 5″2 and 120 pounds. I have very large breasts that leave my back in constant pain and my neck also. I was wondering if it was safe to go from a 34DD cup to a B cup? I’m too tiny for these massive things on my chest!! Aha someone help! Thanks a lot

A: At age 19, I expect your breasts are fully developed. It sounds as if you have significant symptoms related to your overly large breasts (macromastia). You are probably a great candidate for a breast reduction surgery. My breasts reduction patients are some of the happiest women I have met! Please understand that this procedure does produce scars on the breasts, but they are not generally visible under a bra or bikini top. Sometimes breast reduction surgery is covered (at least in part) by your health insurance. For that reason, I recommend scheduling a visit with your primary care physician. Most insurance companies require you to be at a healthy weight (which you are) and that you try conservative therapies – like pain medication and physical therapy first. Medical records from your regular doctor showing that these therapies have not worked as well as documentation of any skin rashes or shoulder grooves you may have can support your insurance claim. I recommend you choose a board certified plastic surgeon who performs breast reduction surgery frequently. Best of luck!